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Post by anonrefugee on Oct 15, 2014 14:37:40 GMT
Even the Dallas Mayor said it going to get worse before it gets better- but it will get better.
It's sad and scary they're having to learn as it happens, but what could have been done differently? Every little hospital in the country be trained, and equipped, instead of using those resources elsewhere?
I know I'll get slapped for this, but we can't always be prepared for all circumstances, all emergencies, all the time. Imagine what would have been said if a hospital spent money last year on Ebola Preparedness? We'd all say crazy- use that money for HIV prep, or cancer, something "real".
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Post by myshelly on Oct 15, 2014 14:38:51 GMT
What is causing people to reach high levels of anxiety is a mistrust in how this is being managed. And given all the unknowns and the high death rate, unlike the flu as people keep trying to compare this too..., I don't believe high levels of anxiety are unfounded. So, hand slap and try to make people feel bad about their reaction but it is ridiculous and unfair. I guess you're meaning my comment - I wasn't handslapping or trying to make her feel bad, I was merely pointing out that in the early stages of an event like this there are going to be mistakes, some mismanaged events etc etc before things get under control and that panicking does nothing except make the person themself feel worse. No one has done this before, not even the experts, but I'm sure that with all those medical experts from around the world focused on this, it will be beaten - it's just going to take a little while. I think the frustration I fell is that, IMO, this was completely foreseeable. Ebola has been an epidemic in Africa for awhile now. It is foreseeable epidemics will spread. It is foreseeable American hospitals will have to deal with this disease. It was not only foreseeable, but actually happened, when American doctors and aide workers were transported back here with Ebola for treatment. Given all of that the CDC should have stepped in and began leading as soon as this issue started in Dallas. My frustration is not with inexperience or mistakes or mismanagement. My frustration is with a government agency that flat out failed to do its job in a completely predictable, foreseeable circumstance that it should have, by definition of the agency's job, been prepared to handle. |
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georgiapea
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Post by georgiapea on Oct 15, 2014 14:40:34 GMT
There are 21 steps to adhere to while removing your contaminated coverings. That's a lot of steps to remember and apparently there are no posters up giving the nurses a step by step guide as they do it. One that boggled my mind is that their hand coverings come off and then the headgear is removed bare handed. My opinion is that once the contaminated gloves are off that new ones need to be put on before touching any other part of the gear.
And as I've said in the past, I believe transference is much easier than CDC is saying. This gives health care workers a false sense of security. |
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Sarah*H
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Post by Sarah*H on Oct 15, 2014 14:45:04 GMT
I don't live in Dallas and I don't need to go to Presbyterian hospital so I'm not panicked or anxious; I think it's well within reason for those persons who do live there or have loved ones who do to be worried about the incompetence with which the hospital administration seems to have handled this so far. The biggest lesson learned should be that just because you make information or training available doesn't mean that it's going to trickle down to those who need to know it so probably the feds (in some capacity) are going to have to make such training mandatory going forward. (Which will inevitably lead to complaints about government overreach and wasteful budgets and bureaucracy, etc. but that seems to be how things work in this country now.)
It's my understanding that the CDC primarily works in a support role, not normally as the primary actor in any of these scenarios whether it be provision of care or clean up, etc. Regardless, on the surface it appears that the CDC response has been inadequate or incompetent - whether that's a problem of leadership, capability, budgets, lack of cooperation or absence of mandate is something that needs to be figured out sooner rather than later. It is another reminder though that we don't want government and we don't want to pay for things until we need them. That the hospital has to order Tyvek suits 2 weeks later is not the fault of Obama or the CDC or anyone but those in charge at that hospital who didn't think it necessary before it was already too late.
I know most of us are scratching our heads about decision making like only quarantining other patients who were exposed for 24 hours or sending potentially ebola infected blood through the hospital's normal tube system or making Mr. Duncan's nurses work with other patients but we've not yet heard any explanations from whoever it was who made these decisions. I'm not sure what it is that those of you who want to hear from the President are wanting to hear but in the meantime, what I'd like is reassurance from my local hospital officials that they are watching what happened in Dallas and won't make similarly poor decisions.
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Post by bc2ca on Oct 15, 2014 14:48:58 GMT
My best guess as to why these nurses have been infected and not the others around Duncan is twofold. One is that the risk of infection grows with the viral load. People seem quite freaked out over someone possibly out in public when they first develop the fever. Rightly so. However, the problem is worse with the person who has been actually ill for a while. As the viral load grows, the risk of someone else contracting the virus grows simply because of the viral load in the bodily fluids. These nurses were taking care of him at his sickest. They may have been there for the intubations and extubations and the dialysis and much more. Two is the so-called protocols and the protective gear. The protective gear they were wearing, I believe, was insufficient. They had skin exposed. To say nothing of removal of the gear and the decontamination that did not occur. My belief, from the news coverage, is that they treated this virus like HIV. Ebola is significantly more contagious than HIV. The CDC does admit that the first mistake they made was not sending in a full team when Duncan was diagnosed. They sent in epidemiologists to help with the contact tracing, etc but did not send in trained nurses. There was some information on the news last night and IIRC, the viral load of Ebola is 10x that of HIV. I hated the blame the victim "nurse became sick because she broke protocol" message that came out initially and am glad there is push back on that. The whole hospital did not have the CDC protocols in place. |
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Post by myshelly on Oct 15, 2014 14:49:08 GMT
I don't live in Dallas and I don't need to go to Presbyterian hospital so I'm not panicked or anxious; I think it's well within reason for those persons who do live there or have loved ones who do to be worried about the incompetence with which the hospital administration seems to have handled this so far. The biggest lesson learned should be that just because you make information or training available doesn't mean that it's going to trickle down to those who need to know it so probably the feds (in some capacity) are going to have to make such training mandatory going forward. (Which will inevitably lead to complaints about government overreach and wasteful budgets and bureaucracy, etc. but that seems to be how things work in this country now.) It's my understanding that the CDC primarily works in a support role, not normally as the primary actor in any of these scenarios whether it be provision of care or clean up, etc. Regardless, on the surface it appears that the CDC response has been inadequate or incompetent - whether that's a problem of leadership, capability, budgets, lack of cooperation or absence of mandate is something that needs to be figured out sooner rather than later. It is another reminder though that we don't want government and we don't want to pay for things until we need them. That the hospital has to order Tyvek suits 2 weeks later is not the fault of Obama or the CDC or anyone but those in charge at that hospital. Re training - Training doesn't matter if the hospital doesn't have the supplies. I don't think this is the job of the hospital. I think it is the job of the CDC. Every hospital in the country cannot outfit itself with gear and disposal systems in case an Ebola patient walks in. The CDC needs to step in and provide that expertise and infrastructure. |
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Post by gar on Oct 15, 2014 14:52:16 GMT
I guess you're meaning my comment - I wasn't handslapping or trying to make her feel bad, I was merely pointing out that in the early stages of an event like this there are going to be mistakes, some mismanaged events etc etc before things get under control and that panicking does nothing except make the person themself feel worse. No one has done this before, not even the experts, but I'm sure that with all those medical experts from around the world focused on this, it will be beaten - it's just going to take a little while. I think the frustration I fell is that, IMO, this was completely foreseeable. Ebola has been an epidemic in Africa for awhile now. It is foreseeable epidemics will spread. It is foreseeable American hospitals will have to deal with this disease. It was not only foreseeable, but actually happened, when American doctors and aide workers were transported back here with Ebola for treatment. Given all of that the CDC should have stepped in and began leading as soon as this issue started in Dallas. My frustration is not with inexperience or mistakes or mismanagement. My frustration is with a government agency that flat out failed to do its job in a completely predictable, foreseeable circumstance that it should have, by definition of the agency's job, been prepared to handle. I can't speak about the CDC because I don't know about it, or really how it's handled events in any depth but I'm pretty sure that the UK equivalent agency will come under criticism when it's our time too....and that won't be long I'm sure. I don't know but I feel confident guessing that there are a LOT of diseases that exist in the world which are known about to a degree but which aren't seen as potential worldwide threats. It'd be impossible for the medical world to work on all the viruses in the world that 'could' potentially start spreading in this way because of a change in whatever it is that causes these things to suddenly explode and become hard to control. |
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Post by Darcy Collins on Oct 15, 2014 15:00:07 GMT
My best guess as to why these nurses have been infected and not the others around Duncan is twofold. One is that the risk of infection grows with the viral load. People seem quite freaked out over someone possibly out in public when they first develop the fever. Rightly so. However, the problem is worse with the person who has been actually ill for a while. As the viral load grows, the risk of someone else contracting the virus grows simply because of the viral load in the bodily fluids. These nurses were taking care of him at his sickest. They may have been there for the intubations and extubations and the dialysis and much more. Two is the so-called protocols and the protective gear. The protective gear they were wearing, I believe, was insufficient. They had skin exposed. To say nothing of removal of the gear and the decontamination that did not occur. My belief, from the news coverage, is that they treated this virus like HIV. Ebola is significantly more contagious than HIV. The CDC does admit that the first mistake they made was not sending in a full team when Duncan was diagnosed. They sent in epidemiologists to help with the contact tracing, etc but did not send in trained nurses. My biggest frustration last week was the CDC insistence that this virus was like HIV. They went so far as to show that nifty graphic about how a patient with HIV is projected to infect the same number of people as one with Ebola (2 incidentally). Utterly and complete ignoring the fact that the patient with HIV will live for as much as a decade and the person with Ebola is likely to live only a few weeks as well as the likelihood of transmission (the HIV patient engaging in unsafe sex before realizing their infected versus the Ebola patient infecting people who live with them and/or care for them while dying). The WHO site was much, much more straightforward regarding the incredibly high viral load during the end of the illness and how contagious the body is - which peaks at death. In a desire to reassure the public they put these nurses at increased risk by sending them in utterly unprepared. I'm going to copy the thread from last week which linked to some of the contradictory info: 2peasrefugees.boards.net/thread/9323/spanish-nurse-contracted-ebolaSorry that wasn't the actual thread I meant - the contradictory info with the graph was in this thread (ignore the 2 page debate on Cuba): 2peasrefugees.boards.net/thread/8903/thread-confirmed-ebola-case-texasI posted this on that thread on Oct 1 and think it is still true today: |
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Sarah*H
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Post by Sarah*H on Oct 15, 2014 15:09:21 GMT
I don't disagree and I'm certainly not defending the CDC, I said they appear to have handled this incompetently. I think we need to figure out WHY that is and fix it. If the head of the CDC is a terrible and ineffecient leader, fire him. If they need more money or more staff, give it to them. If they need the authority to force hospitals to do the training, give it to them. If they need some kind of decree to take over patient care in a private facility, get it. At the moment, this looks like a clusterfuck similar to FEMA and Katrina but the clusterfuck is also not ALL on the CDC. If some random woman in Liberia knows enough to google and wear garbage bags and duct tape to protect herself while she cares for her family, the administration in highly rated hospitals could at least manage that degree of care when training and protecting their staff once the illness is in the facility.
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Post by Darcy Collins on Oct 15, 2014 15:18:01 GMT
I think the problem is over confidence. We're not a third world country. The people being infected in Africa are ignorant and scared of modern medicine. It's just like HIV. We have the medical infrastructure. All messages the CDC sent to calm public fears and completely ignored the huge number of medical personnel who have contracted Ebola in Africa.
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Post by Anna*Banana on Oct 15, 2014 15:19:42 GMT
I don't live in Dallas and I don't need to go to Presbyterian hospital so I'm not panicked or anxious; I think it's well within reason for those persons who do live there or have loved ones who do to be worried about the incompetence with which the hospital administration seems to have handled this so far. The biggest lesson learned should be that just because you make information or training available doesn't mean that it's going to trickle down to those who need to know it so probably the feds (in some capacity) are going to have to make such training mandatory going forward. (Which will inevitably lead to complaints about government overreach and wasteful budgets and bureaucracy, etc. but that seems to be how things work in this country now.) It's my understanding that the CDC primarily works in a support role, not normally as the primary actor in any of these scenarios whether it be provision of care or clean up, etc. Regardless, on the surface it appears that the CDC response has been inadequate or incompetent - whether that's a problem of leadership, capability, budgets, lack of cooperation or absence of mandate is something that needs to be figured out sooner rather than later. It is another reminder though that we don't want government and we don't want to pay for things until we need them. That the hospital has to order Tyvek suits 2 weeks later is not the fault of Obama or the CDC or anyone but those in charge at that hospital who didn't think it necessary before it was already too late. I know most of us are scratching our heads about decision making like only quarantining other patients who were exposed for 24 hours or sending potentially ebola infected blood through the hospital's normal tube system or making Mr. Duncan's nurses work with other patients but we've not yet heard any explanations from whoever it was who made these decisions. I'm not sure what it is that those of you who want to hear from the President are wanting to hear but in the meantime, what I'd like is reassurance from my local hospital officials that they are watching what happened in Dallas and won't make similarly poor decisions. I'm not wanting or needing to hear from the president nor am I freaking out. I was supporting those who are being hand slapped for feeling anxious. |
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Post by DinCA on Oct 15, 2014 15:21:37 GMT
It's being reported that 77 hospital employees came into contact with Duncan. This shocks me. I don't know why but I assumed it would be a small team of people who took care of him to reduce risk. They are all monitoring their temperature either at home or at the hospital. And they are expecting more to become sick.
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Sarah*H
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Post by Sarah*H on Oct 15, 2014 15:23:19 GMT
I was referring to Stacy71 who keeps asking where the President is and demanding a travel ban which all the experts say would accomplish nothing. It's that kind of overwrought and illogical response which is frustrating.
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Post by Darcy Collins on Oct 15, 2014 15:24:38 GMT
I would also say there's no reason to outfit every hospital in the US for an Ebola patient. If the CDC would have accepted the fact that this is a highly contagious condition and requires special training - they would have moved patient zero out of Dallas and to a facility that could care for him (like Emory where they brought the infected missionaries) and the nurses wouldn't have been infected. It's the continued insistence that it's really not that contagious that is ridiculous.
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Post by Darcy Collins on Oct 15, 2014 15:27:27 GMT
I was referring to Stacy71 who keeps asking where the President is and demanding a travel ban which all the experts say would accomplish nothing. It's that kind of overwrought and illogical response which is frustrating. I totally disagree that a travel ban would accomplish nothing. The comment from the head of the CDC was that it wouldn't reduce the risk to zero - is obvious. A ban on visas from the countries with the highest risk would absolutely reduce the risk of another patient coming into the US with Ebola. |
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Sarah*H
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Post by Sarah*H on Oct 15, 2014 15:31:25 GMT
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Post by PEAcan pie on Oct 15, 2014 15:34:47 GMT
News reports are indicating the new Ebola patient flew THE DAY BEFORE diagnosis. Not good!
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Deleted
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Aug 18, 2025 19:37:44 GMT
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Post by Deleted on Oct 15, 2014 15:36:11 GMT
It appears the 2nd Ebola nurse, diagnosed today, flew on a flight from Cleveland to Dallas Monday night. She reported to work Tuesday morning with a low grade fever...and now the diagnosis.
The CDC is requesting all of those on that flight (Frontier Airlines...can't recall flight number...I was driving when I heard it) to check in with them.
I wasn't at all confident from the beginning. People said the CDC had it under control...no worries. I said if the hospital failed its very first test...by sending Duncan home after first hospital visit.
Failures continue...and now they're going to have to watch 130 or so people on that flight.
We are SO not ready for this.
(and as much as I loathe President Obama, I don't really see why we need to "hear" from him on this) |
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Post by PEAcan pie on Oct 15, 2014 15:36:23 GMT
The second Dallas health care worker with Ebola was on a flight from Cleveland to Dallas on Monday -- the day before she reported symptoms, the Centers for Disease Control and Prevention said Wednesday. Because of the proximity in time between the Monday evening flight and the first report of her illness, the CDC wants to interview all 132 passengers on her flight -- Frontier Airlines Flight 1143 from Cleveland to Dallas/Fort Worth, which landed at 8:16 p.m. CT Monday, the CDC said.
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Just T
Drama Llama
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Post by Just T on Oct 15, 2014 15:41:59 GMT
Sigh. Wouldn't you think that when one coworker who took care of him came down with Ebola that the other workers would have been put under some sort of quarantine? I can't believe she got on a plane when she knew that one of her coworkers who cared for Duncan was sick. UGH. If nothing else, she should have kept herself away from people just because it was the right thing to do, even if she wasn't officially quarantined.
So, Duncan got a pass on traveling because he maybe didn't know the woman he helped care for died of Ebola. This nurse surely knew she was at risk, yet flew anyway. UGH. |
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Post by cynipidae17 on Oct 15, 2014 15:44:12 GMT
I just find the whole situation heartbreaking and pray the nurses have a full recovery
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Post by Darcy Collins on Oct 15, 2014 15:45:40 GMT
Thanks for posting the article. It's an interesting study, but they pretty much ignored the ability to restrict Visas for the highest risk population. They simply looked at where people travel to and through and what would happen if a country restricted air travel (no surprise the risk went down, but didn't go to zero). I think there should be a vigorous debate the pros and cons of travel restrictions, I don't think there should be continued false assertions that either as a country the US can't implement travel restrictions or that they would do nothing. Even in the study you posted despite my disagreements with the analysis, it showed a significant short term reduction of the risk of importing the virus. A reduction that might prove useful in getting the US better prepared, or helping the African nations deal with the epidemic. |
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Post by anonrefugee on Oct 15, 2014 15:47:51 GMT
Controlling flights might not stop the inevitable, but an extra month or two to prepare couldn't hurt- could it? So I'm not sure the study cited above disproves need to control flights.
But having said that - I can't fathom how we could realistically do it.
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melissa
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Post by melissa on Oct 15, 2014 15:53:02 GMT
I believe EVERY hospital in the country is watching closely and paying attention.
This is why we have had all these reports of "possible" cases, all of which have turned out to be false alarms. It's because everyone is finally watching and learning.
We have a conference scheduled at our hospital today on the very topic. This is not the first time it has been addressed. It continues to be addressed and readdressed daily. It's bringing an awareness of other infectious diseases to the forefront as well. What I think is key is that it is not just doctors and nurses involved in the education process. EVERYONE is involved from the security team to the clerks and volunteers.
I am concerned about those 77 healthcare employees involved in the care of Mr. Duncan. They are monitoring themselves for symptoms but, knowing that one was on an airplane just before she developed the first sign is a great concern. If we are insisting that Nancy Snyderman and her crew be in quarantine, many of these folks had much more contact with an infected person with a higher viral load than she did.
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Deleted
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Aug 18, 2025 19:37:44 GMT
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Post by Deleted on Oct 15, 2014 15:54:36 GMT
I was just watching a report that the CDC can't step in unless the hospital asks. That is policy. Has the hospital asked for help in this? I see lots of blame thrown around but that doesn't solve anything. It is a learning curve. We've never dealt with this here. But that doesn't mean we aren't learning and quickly.
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Post by Darcy Collins on Oct 15, 2014 15:58:24 GMT
Controlling flights might not stop the inevitable, but an extra month or two to prepare couldn't hurt- could it? So I'm not sure the study cited above disproves need to control flights. But having said that - I can't fathom how we could realistically do it. You have to have a Visa to travel from any African country to the US. Just restricting Visas would limit the risk. It is certainly more difficult to restrict entry to any one who has been in those nations in the last month - but the highest risk is residents who are living in countries with epidemics. |
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Peamac
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Post by Peamac on Oct 15, 2014 15:58:50 GMT
Too bad the CDC can't make a video of how some of these procedures are supposed to be done and put it on their website so all hospitals, clinics, etc can see what they are supposed to be doing. It can be updated as necessary, when new information is discovered.
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Post by bingcherry on Oct 15, 2014 16:00:48 GMT
As an RN working in acute care/hospitals for the past 17 years, this is definitely concerning to me. The small community hospital I work in would absolutely not be prepared to take care of a patient with Ebola, or any other highly transmittable disease. I think it's deplorable that the nurses are being blamed for infecting themselves. The CDC should have stepped in as soon as Duncan was diagnosed to assist hospital and train the staff properly. They definitely dropped the ball. All infective material should have been bagged and then double bagged before leaving the room.
In all seriousness, I more than likely would risk losing my job than to take care of a patient with Ebola. I'm sure that doesn't sit well with many people and while I understand that I have a professional responsibility to my employer, I also have a responsibility to my family.
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Post by scrapsotime on Oct 15, 2014 16:03:35 GMT
I was just watching a report that the CDC can't step in unless the hospital asks. That is policy. Has the hospital asked for help in this? I see lots of blame thrown around but that doesn't solve anything. It is a learning curve. We've never dealt with this here. But that doesn't mean we aren't learning and quickly. The CDC did send an epidemiologist (not sure if he was part of a team or not) and have said they wished they would have sent a larger team including nurses who where trained. |
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Deleted
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Post by Deleted on Oct 15, 2014 16:11:30 GMT
In all seriousness, I more than likely would risk losing my job than to take care of a patient with Ebola. I'm sure that doesn't sit well with many people and while I understand that I have a professional responsibility to my employer, I also have a responsibility to my family. I can't say that I blame you. The CDC (who IMO should be taking the lead over any individual hospital) and this specific hospital have failed miserably.
And I agree...we're all pissed that Dr. Nancy Sniderman escaped quarantine...but this nurse, who treated Duncan...who works with a nurse who treated Duncan was also positive flies on a plane?
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